Introduction: obstetric morbidity and maternal mortality are defined as the probability that a woman who has been or is pregnant will become ill or die. Objective: characterization of the obstetric patient in critically surgical state admitted to the Intensive Care Unit (ICU) at the Hospital General Docente "Vladimir Ilich Lenin" in Holguín province. Method: a descriptive, longitudinal, retrospective study was conducted from January 1 to December 31, 2021. The universe studied consisted of 90 pregnant women in critically surgical state admitted to the ICU (sample=universe). It was identified: age, physical status according to the American Society of Anesthesiologists, associated diseases, anesthetic technique used, diagnosis on admission to the intensive care unit, and mortality. The results were recorded in an electronic database and the descriptive statistics were applied. Results: obstetric patients with physical status II according to the American Society of Anesthesiology, between 20 to 29 years of age with a history of arterial hypertension were the most likely to be admitted to the Intensive Care Unit, the direct causes being: mainly obstetric hemorrhage, seconded by aggravated preeclampsia and sepsis; indirect causes: non-obstetric surgery, such as acute appendicitis. General anesthesia was the most commonly used anesthetic technique. Mortality was low and indirect cause. Conclusions: the results agree with those published by other authors, which show the importance of multidisciplinary care from primary health care to secondary care.

Introduction: elders are a topic of interest and attention on the part of society in general, not only because for demographic reasons they are increasingly numerous, but also because of the growing sensitivity to the social situations they present. Objective: to characterize the subjective perception of loneliness in elderly people living alone belonging to a health control area in Santiago de Cuba, during the period June to October 2021. Method: a descriptive, cross-sectional study was carried out in a sample of 14 elderly through purposive non-probabilistic sampling. Instruments used for the evaluation were: semi-estructure interview, Social Support Questionnaire (CAS-7), Scale of Loneliness in the Elderly (IMSOL-AM), Scale of Psychological Well-being for Adults (BIEPS-A) and Satisfaction With Life Scale (SWLS). Results: there was a predominance of subjects of the female sex, widows and with ages between 70 to 80 years. Feelings of loneliness were not appreciated in most of them. The perception of health that prevailed was regular, with medium and dense support networks that perceived the need for social support, instrumental support being the most demanded. High scores were presented in psychological well-being, as well as in satisfaction with life. Conclusions: loneliness impacts subjectively from the assessment of their reality, and is determined by the relationship between expectations and what they get with their intimacy. In this sense, the appearance of the feeling of loneliness was mostly related to the perception of health, self-efficacy and its influence on the psychological well-being variables.

Introduction: arbovirus infections are a serious health problem in Peru. Higher population awareness and their participation in preventive activities can minimize their impact. Objective: assessment on the level of knowledge and its relationship with preventive measures concerning arbovirus infections in university students in an endemic area of Peru, September to November 2020. Method: an observational, cross-sectional, correlational and non-experimental design study was carried out. The population consisted of 325 medical technology students and the sample consisted of 176 students of both sexes. The level of knowledge was categorized as deficient, regular and high. Preventive measures were classified as adequate and inadequate. The questionnaire contained 23 multiple-choice questions, validated by expert judgment. Results: the knowledge level in 69.9% of the students was fair, and inadequate preventive measures were observed in 44.3%. The 92.0% of surveyed personnel considered the arbovirus infection as a serious disease, but only 10.2% recognized the warning sign of zika. The main preventive measures were: fumigation (50.6%) and the use of repellents (49.6%). In addition, 92.6% of students considered as an important action the act to eliminate mosquito breeding sites in order to prevent the spread of infection. However, only 51.1% checked for the presence of breeding sites and cleaned their homes on a daily and inter-daily basis (43.8%). Conclusions: the level of knowledge was regular and was related to inadequate preventive measures such as not frequently checking for the presence of mosquito breeding sites and not cleaning houses.

Introduction: oral cancer is a common health problem worldwide. Objective: compare the salivary pH range changes among patients diagnosed recently with oral squamous cells carcinoma after receiving oncospecific treatment and subjects apparently healthy, Guantanamo, Cuba, period time November 2019 -January 2022. Method: a descriptive, comparative, cross-sectional study was carried out in outpatients of the Maxillofacial Surgery Consultation room at the Hospital General Docente "Dr. Agostinho Neto". The study group consisted of 200 patients divided into 3 subgroups: subgroup I (50 newly diagnosed patients with oral squamous cell carcinoma, with concomitant diagnosis of dental caries and chronic adult periodontitis); subgroup II (50 patients with the aforementioned pathology after oncospecific treatment, treated for the aforementioned oral diseases) and subgroup III (100 apparently healthy control patients). The following variables were studied: age, sex, type of diet and salivary pH. Results: average age was 59.8 years, 70% were men. There was an association between the diet consumed and each subgroup (p=0.001). The salivary pH of newly diagnosed squamous cell carcinoma patients affected by both oral diseases was acidic (6.25±0.37) compared to the other subgroups. The 98.6% of patients with acid salivary pH presented a usual diet based on carbohydrates and fats (p=0.000). Conclusions: it was shown that the salivary pH of newly diagnosed patients with squamous cell carcinoma was acidic compared to the other subgroups. Therefore, this parameter can be used as a biological marker of the disease.

Introduction: the first description of microscopic colitis was made in 1976. Currently, it groups three subgroups of pathologies, the classic lymphocytic colitis and collagenous colitis, the third subgroup corresponds to incomplete microscopic colitis. Objective: to identify the main factors associated with the development of microscopic colitis at the Hospital General Provincial "Carlos Manuel de Céspedes", Bayamo, Granma, from March 2019 to August 2021. Method: an observational, analytical study of cases and controls was carried out in patients aged 18 years or older with chronic watery diarrhea treated at the gastroenterology service. The variables studied were: presence of microscopic colitis, age, sex, smoking habit, use of medications, comorbidities, abdominal pain, fatigue, fecal incontinence and weight loss. The sample size for paired studies was determined using the STATA 17 program. For its estimation, the following were considered: confidence level, statistical power of the test, ratio of cases and controls and minimum Odds Ratio. Results: there was no association between age over 50 years and the probability of presenting colitis. The female sex prevailed (62.5%). Of the total number of patients with microscopic colitis (n=16), 62.5% smoked. The OR obtained indicated that smoker patients have 2.5 times more risk. Diabetes mellitus was significantly associated with the diagnosis of microscopic colitis and increased the risk fivefold. Conclusions: there is a relationship between female sex, smoking, diabetes mellitus, cholecystectomy, consumption of three or more drugs and fecal incontinence with the presence of microscopic colitis.

Introduction: birth weight is a key determinant of infant morbidity and mortality. Objective: determine the risk factors associated with low birth weight in patients with critical infant morbidity in Cacocum municipality, Holguín, Cuba, during the period May 2, 2021 to May 1, 2022. Methods: a cross-sectional descriptive observational study was carried out. The population was comprised of 798 live births during the study period and the sample consisted of 25 patients with critical infant morbidity, obtained by non-probabilistic purposive sampling. The primary data were obtained from the infant critical morbidity discussion surveys. The variables studied were at following: age, sex, gestational age at delivery, birth weight, prenatal history, perinatal history, and postnatal history. Results: both male patients (72%) and group age 1 to 30 days (76%) were predominant. There was no difference between preterm and term births and between low birth weight and normal weight births. There was a statistically significant relationship between gestational hypertensive disease and intrauterine growth restriction with respect to low birth weight. The predominant morbidity was respiratory distress syndrome in low birth weight infants (80%). Conclusions: gestational hypertensive disease and intrauterine growth restriction are risk factors associated with the low birth weight in critical infant morbidity.

Introduction: brain tumors are a heterogeneous group given the different cells that originate them. The most frequent brain tumors are those derived from the glia, with astrocytomas being the most common. Objective: to systematize the findings of studies that examined multiple prognostic factors for survival in patients with astrocytoma-type brain tumors. Method: a systematic review of observational, analytical, prospective studies was carried out. The bibliographic search was carried out in the electronic databases Medline, SciELO, LILACS, PubMed and Google Scholar, with the following descriptive terms: age, sex, prognostic factors, brain cancer, astrocytoma. Results: the search found 136,452 articles that were distributed in different databases. When applying the eligibility criteria, 13 articles remained for analysis. In the case of prognostic factors dependent on the lesion, tumor or disease, most researches showed a tendency to evaluate the histologic grade and the histology of the lesion. In the case of the patient-dependent prognoses, there was a greater inclination towards age, sex and the symptoms presented, while in those dependent on the treatment, the treatment modalities suggested to the patients were shown indistinctly: surgery, chemotherapy and radiotherapy. Conclusions: in this research, the main prognostic factors contained in the literature about patients with astrocytic tumors were presented, which are grouped into prognostic factors depending on the tumor, the patient and the treatment. These must be taken into account to evaluate the patient with these brain tumor lesions.

Introduction: patient safety is a challenge for nurses, so it is necessary to develop, monitor and evaluate quality and safety indicators that are measurable, objective, relevant and based in real evidence. Objective: to describe the perceptions concerning the patient safety culture among the nursing staff of the Critical care service in a mother and child hospital in the Ciudad Autónoma de Buenos Aires. Method: an observational, descriptive, cross-sectional, descriptive study was conducted between August and October 2021. The accessible population consisted of 57 nursing professionals. The Hospital Survey on Patient Safety Culture was used as an instrument. Results: after analyzing the perceptions according to dimensions, it was found that the dimension with the highest values was 7 at feedback and communication about errors. The rest of the dimensions obtained scores in neutral range, with values less than or equal to 4 points. The Kruskal-Wallis test was applied, and no statistically significant differences were found between the groups in any of the four variables analyzed. Conclusions: in the analysis concerning patient safety culture found non-negative perceptions where feedback and communication about errors was the only dimension with a positive score among the nurses surveyed. Finally, it should be noted that it was not possible to establish that the organizational culture of patient safety was conditioned by sociodemographic or training indicators.

Introduction: chronic urticaria is a heterogeneous demarcated skin disease characterized by the development of wheals or hives. Objective: determination of the clinical characteristics and the pharmacological treatment indicated in patients diagnosed with chronic urticaria. Method: a quantitative, prospective, observational and descriptive study was conducted in a total of 48 patients (the universe) diagnosed with chronic urticaria, Main Military Hospital, Guinea-Bissau, 2018-2020. The following variables were used: age, sex, type of urticaria, time of evolution, comorbidity and treatment used in the first and last recorded consultation, as well as disease activity. Results: the mean age was 38.52 years with a female predominance. The mean time of evolution of the disease was 4.67 years and 70.83% did not present angioedema. Chronic spontaneous urticaria was the predominant type. cyproheptadine was the treatment most indicated to be used at baseline and at the end of treatment follow-up its use increased. montelukast was the other drug that increased its use at the end of follow-up. With the treatment used disease activity was reduced up to rates recognized as controlled chronic spontaneous urticaria. Conclusions: chronic urticaria in Guinea-Bissau has prevalence and clinical manifestations in line with those reported worldwide, with treatment regimens susceptible to modifications depending on the early use of recommended drugs such as cyclosporine or omalizumab.

Introduction: COVID-19 vaccines stimulate immune processes that allow SARS-CoV-2, which affected a large part of the population, to be mitigated. The research on the adverse reactions presented by the COVID-19 vaccines must be continuous, since at present there is not enough information on their consequences. Objective: to determine the possible adverse reactions in young and older adults belonging to the Recinto Umpechico, inoculated against SARS-CoV-2 in Santo Domingo, during 2021. Method: a descriptive study was carried out in a population of 600 residents of said locality, inoculated against SARS-CoV-2. Non-probability convenience sampling was used, with a sample of 235 inhabitants. The study variables were: adverse reactions to COVID-19 vaccines, name of the vaccine received, number of doses, intensity and duration of symptoms, medications used to mitigate said adverse reactions. Results: 31.5% of the respondents who presented symptoms were male. The most common vaccine was Pfizer with 47.65%, with a percentage of symptoms of 29.36%. The most common adverse reaction was arm pain with 31.98%, lasting two to three days, equivalent to 48.96%; 62.65% used paracetamol and 20.5% used cold water baths to reduce symptoms. Conclusions: the vaccines manufactured by the different pharmaceutical companies cause adverse reactions that range from mild to severe, manifesting at any age and for a short or long term, which in most cases are easily treated with pharmacological and non-pharmacological medications.

Introduction: universal neonatal hearing screening is a test that enables to identify or suspect hearing loss, performed via habilitation or rehabilitation plan. Objective: determine the coverage of universal hearing screening in the epidemiological context of COVID-19 in Guantánamo province, during the period of march 2020 to march 2021. Method: a descriptive, retrospective cross-sectional study was carried out. A total of 5 999 newborns (as Universe) were involved in the study. Variables used were as follow: sex, newborns with or without risk factors, and otoacoustic emissions, which outcomes allowed for the evaluation of universal hearing screening coverage. The standard indicator (95%) and the time at which the first otoacoustic emissions were made were defined. The percentage of newborns detected before one month of life was established as indicator. Results: the 51.1% of the 5 999 newborns were male and 48.3% were female. The 100% of newborns (5 838) without risk factors underwent to the first examination, meanwhile, among those with risk factors (151 newborns) 0.2% (10) could not be tested. Screening of newborns without factors occurred between 1 and 3 days after birth. Screening was never performed after 30 days of birth in those who presented risk factors. Coverage was 99.8% and the reference rate was 0.2%. Conclusions: Universal Hearing Screening Program application in the context of COVID-19 pandemic in Guantanamo province shows a fulfillment in the coverage indicator.

A nine-year old female patient presented with a history of trauma to the upper central incisors. She received treatment for apicoforming with calcium hydroxide for a prolonged period, who after root canal obturation presented acute inflammation of the upper lip and buccal vestibule. Treatment included antimicrobial therapy, extensive surgical debridement under general anesthesia, apicoectomy of both incisors, and direct visual obturation of the canals and apical sealing of the teeth with gutta-percha. The anatomopathologic diagnosis was acute chronic osteomyelitis of the maxilla. One and a half years later, clinical absence of inflammatory signs and adequate healing of the bone tissue were observed. It was concluded that, although reports concerning chronic osteomyelitis of the maxillary bone are rare events, this type of infection should be always present at the time of the differential diagnosis for evaluating pediatric patients with a history of dentoalveolar trauma and inflammatory processes in the maxillofacial region.

Introduction: didactic strategies, as a whole, demand the establishment of a dialogical, constant and triangular relationship between educators, learners and methodologies, even though the learner is unaware or not of the methodologies used by the professor for purpose required. Objective: to validate a manual for designing and elaborating a didactic strategy to enhance the information level for medical students concerning COVID-19. Method: a manual based on a didactic strategy structural design was elaborated with the porpuse of increase the knowledge for the second year medical students at the Universidad de Ciencias Médicas de Sancti Spíritus, Cuba, on the signs, symptoms of COVID-19 and the prevention methods used at the beginning of the pandemic in the country. Thirty national experts in medical education sciences gave their opinions on the relevance of the didactic strategy and about the structural design of the manual, which were analyzed by the Delphi method. The success of the strategy implementation was assessed implementing tests to the studied population before and after the introduction of the didactic strategy in the period 2021- 2022. Results: the experts’ opinion concerning the fundamentals underpinning the didactic strategy for higher medical education and the quality of the proposed manual was highly favorable in general consensus. Conclusions: both the educational strategy and the elaboration of the manual were validated by the experts for its application in higher medical education and in particularly for the detection and containment of COVID-19.

Introduction: in the teaching-learning process for the students of Stomatology, it is necessary to verify the mastery of knowledge, actions, operations and attitudes for the prevention of oral cancer. Objective: performing a methodological instrument that allows the evaluation of the development of the skill of early diagnosis of oral cancer in fifth year Stomatology students. Method: an educational, descriptive research with a mixed approach was carried out at the University of Medical Sciences in Guantánamo. The universe was constituted by the teachers and students of the fifth year of stomatology, from which a probability sample of 95 students and 20 teachers was chosen. For gathering the information some theoretical methods were used: historical-logical, analysis and synthesis, inductive-deductive, whereas empirical methods were also used: documentary analysis and the criteria of specialists to validate the proposal. Results: this methodological instrument showed a clear and flexible design for the evaluation of the development of the skill of early diagnosis of oral cancer in fifth year Stomatology students. Specialists as a whole considered it to be relevant, useful and feasible. Conclusions: the proposal will allow to evaluate the acquired ability of the fifth year Stomatology students for the early diagnosis of oral cancer, being considered a contribution for increasing the quality of the training process, and to guarantee that once they graduated they fulfill their social task according to the objectives of the Program for the Early Detection of Oral Cancer.